Association Between Nicotine Dependence and Physical Activity Levels in Young Adults: A Systematic Review

Background Nicotine dependence is a common problem among young adults and has been associated with decreased physical activity and impaired physical performance. Understanding the effects of smoking and nicotine use on fitness is essential for young adults, athletes, and military personnel. Methods A systematic search of PubMed, Scopus, and Google Scholar identified studies published between 2000 and 2024 that examined associations between smoking, nicotine use, physical activity, and physical performance in individuals aged 18–30 years. Thirteen cross-sectional, cohort, longitudinal, and interventional studies met the inclusion criteria. Data on physical activity, fitness outcomes, and lung function were extracted. The risk of bias was assessed via the ROBANS-2 tool. Results Smoking was consistently associated with lower physical activity and reduced physical performance. Approximately 43.2% of the participants engaged in inadequate physical activity, with smokers being less active. Heavy smokers were more likely to be inactive, and smokers had nearly fivefold higher odds of unsatisfactory physical activity (OR = 4.88). Smoking impaired lung function, with reductions in forced vital capacity, forced expiratory volume in 1 second, and aerobic and anaerobic fitness. Longitudinal evidence has indicated a progressive decrease in lung function among smokers. Isolated nicotine exposure did not improve anaerobic performance, although minor effects on pain perception were observed. Participation in team sports was protective against smoking initiation. Conclusions Smoking and nicotine use have deleterious effects on physical activity, lung function, and physical performance in young adults. Physical activity, particularly team sports, may prevent smoking. The combination of smoking cessation and activity promotion is critical to improving youth health outcomes.